Multi-strategy instructional intervention for healthy eating intention among school going adolescents: a quasi-experimental study.

Abstract

Background: Adolescence is a distinct stage of life characterized by significant physical, psychological, and cognitive development. Maintaining healthy eating behaviors during this period is crucial for preventing various forms of malnutrition and non-communicable diseases (NCDs), such as diabetes, heart disease, stroke, and cancer. This study aimed to assess the effects of educational interventions based on the theory of planned behavior (TPB) on improving the healthy eating intention of adolescents in selected schools in Bardiya District.

Methods: A quasi-experimental study was conducted among eighth and ninth graders aged between 12 and 18 years from two public schools in Badhaiyatal Rural Municipality of Nepal, one as an intervention (IG) and the other as a control group (CG), selected randomly. A total of 167 students participated in the study, with 82 in the IG and 85 in the CG. Data were collected through self-administered questionnaires at baseline and4 weeks after the intervention. The intervention package consisted of an interactive lecture, a group discussion, a poster, an educational video, and a song. In contrast, the control group followed the regular school curriculum without any additional nutrition education. The educational intervention for the IG consisted of 6 sessions, each lasting 60 min. Data were entered and analyzed in SPSS V22, using a chi-square test, paired t-test, and linear regression.

Results: The educational intervention led to significant improvements in knowledge and TPB constructs, with these changes being statistically significant (p < 0.001). The adjusted mean score increases in TPB constructs because the interaction of time and intervention increased from 0.47 to 5.49. The highest gain (β = 5.49; p = 0.001) was observed in the perceived behavioural control score whereas, a minor improvement was seen in behaviour (β = 0.47; p = 0.112). After the intervention, a net increase in the healthy eating intention score was 14.8% compared with that of the control group.

Conclusions: The study concluded that multipronged educational intervention may be effective in improving adolescents' healthy eating intentions, mainly through perceived eating control and attitude. Model-based and construct-oriented health education can be used with caution in schools to promote healthy eating intentions.